title: Local treatment of oligometastatic recurrence in patients with resected non-small cell lung cancer.
abstract: OBJECTIVE
  We previously reported a retrospective study indicating the prognostic impact of the local treatment of oligometastatic recurrence after a complete resection for non-small cell lung cancer (NSCLC). In the present study, we prospectively observed postoperative oligometastatic patients and investigated the effects of local treatment on progression-free survival (PFS).
  
  
  METHODS
  Using a prospectively maintained database of patients with completely resected NSCLC treated between October 2007 and December 2011, we identified 52 consecutive patients with postoperative recurrence, excluding second primary lung cancer. Of these patients, 31 suffering from distant metastases alone without primary site recurrence were included in this study. According to the definition of 'oligometastases' as a limited number of distant metastases ranging from one to three, 17 patients had oligometastatic disease. Of those 17 patients, four patients with only brain metastasis were excluded from the analysis.
  
  
  RESULTS
  The oligometastatic sites included the lungs in five patients, bone in four patients, the lungs and brain in two patients, the adrenal glands in one patient and soft tissue in one patient. Eleven of the 13 patients first received local treatment. Three patients (lung, adrenal gland, soft tissue) underwent surgical resection, and the remaining eight patients received radiotherapy. The median PFS was 20 months in the oligometastatic patients who received local treatment. There were five patients with a PFS of longer than two years. The metastatic sites in these patients varied, and one patient had three lesions. On the other hand, the two remaining patients first received a systemic chemotherapy of their own selection. The PFS of these two patients was five and 15 months, respectively.
  
  
  CONCLUSIONS
  Local therapy is a choice for first-line treatment in patients with postoperative oligometastatic recurrence.
authors.affiliation: Department of Thoracic Surgery, National Hospital Organization Beppu Medical Center, Japan. Electronic address: tokujiro@beppu.hosp.go.jp.
authors.forename: Tokujiro
authors.initials: T
authors.lastname: Yano
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Okamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Haro
authors.forename: Seiichi
authors.initials: S
authors.lastname: Fukuyama
authors.forename: Tsukihisa
authors.initials: T
authors.lastname: Yoshida
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Kohno
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000532:radiotherapy / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis* / Q000532:radiotherapy; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Local therapy; Non-small cell lung cancer; Oligometastases; Postoperative recurrence; Progression-free survival